Subclinical Thyroid Dysfunction and the Heart
Authors: Bernadette Biondi, Emiliano A. Palmieri, Gaetano Lombardi, Serafino Fazio
Journal: Annals of Internal Medicine (2003)

Letters18 November 2003Subclinical Thyroid Dysfunction and the HeartBernadette Biondi, MD, Emiliano A. Palmieri, MD, Gaetano Lombardi, MD, and Serafino Fazio, MDBernadette Biondi, MDFrom University of Naples Federico II School of Medicine; 80131 Naples, Italy.Search for more papers by this author, Emiliano A. Palmieri, MDFrom University of Naples Federico II School of Medicine; 80131 Naples, Italy.Search for more papers by this author, Gaetano Lombardi, MDFrom University of Naples Federico II School of Medicine; 80131 Naples, Italy.Search for more papers by this author, and Serafino Fazio, MDFrom University of Naples Federico II School of Medicine; 80131 Naples, Italy.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-10-200311180-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:As indicated by Auer and colleagues, their large cross-sectional study (1) does have a bearing on our study. Indeed, their findings of a similar relative risk for atrial fibrillation in patients with subclinical hyperthyroidism (serum TSH level 0.4 mU/L) and patients with overt hyperthyroidism (serum TSH level <0.03 mU/L), and an almost 3-fold (95% CI, 1.3-fold to 5.8-fold) higher risk versus euthyroid controls (P < 0.01), strengthen the concept that thyroid secretion need not increase much for atrial fibrillation to occur and that subclinical hyperthyroidism itself may precipitate atrial fibrillation and associated sequelae, especially in the elderly. We ...References1. Auer J, Scheibner P, Mische T, Langsteger W, Eber O, Eber B. Subclinical hyperthyroidism as a risk factor for atrial fibrillation. Am Heart J. 2001;142:838-42. [PMID: 11685172] CrossrefMedlineGoogle Scholar2. Sawin CT, Geller A, Wolf PA, Belanger AJ, Baker E, Bacharach P, . Low serum thyrotropin concentrations as a risk factor for atrial fibrillation in older persons. N Engl J Med. 1994;331:1249-52. [PMID: 7935681] CrossrefMedlineGoogle Scholar3. Andersen S, Pedersen KM, Bruun NH, Laurberg P. Narrow individual variations in serum T(4) and T(3) in normal subjects: a clue to the understanding of subclinical thyroid disease. J Clin Endocrinol Metab. 2002;87:1068-72. [PMID: 11889165] CrossrefMedlineGoogle Scholar4. Huber G, Staub JJ, Meier C, Mitrache C, Guglielmetti M, Huber P, . Prospective study of the spontaneous course of subclinical hypothyroidism: prognostic value of thyrotropin, thyroid reserve, and thyroid antibodies. J Clin Endocrinol Metab. 2002;87:3221-6. [PMID: 12107228] CrossrefMedlineGoogle Scholar5. Kahaly GJ. Cardiovascular and atherogenic aspects of subclinical hypothyroidism. Thyroid. 2000;10:665-79. [PMID: 11014311] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Naples Federico II School of Medicine; 80131 Naples, Italy.Acknowledgment: The authors thank Jean Ann Gilder for general collaboration. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffects of Subclinical Thyroid Dysfunction on the Heart Bernadette Biondi , Emiliano A. Palmieri , Gaetano Lombardi , and Serafino Fazio Subclinical Thyroid Dysfunction and the Heart Johann Auer , Robert Berent , and Bernd Eber Subclinical Thyroid Dysfunction and the Heart A. M. Sawka and V. Fatourechi Metrics 18 November 2003Volume 139, Issue 10Page: 866-867KeywordsAtrial fibrillationCardiovascular disease riskHeartHyperthyroidismHypothyroidismLipid metabolismRelative riskThyroidThyroid-stimulating hormoneThyroxine ePublished: 18 November 2003 Issue Published: 18 November 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...